Children at highest risk of death in DR Congo Ebola outbreak, says MSF

Médecins Sans Frontières has raised an alarm over rising Ebola cases in DR Congo, saying the youngest children face the highest risk of death.

“The Ebola disease outbreak in the Democratic Republic of Congo is disproportionately impacting children, with the youngest children facing the highest risk of death,” MSF said on Thursday. “Children are also being left behind in the research of innovative medical tools. Ongoing and future studies on Bundibugyo virus, the virus driving this outbreak, must include children.”

According to the humanitarian organisation, while children faced a higher risk of death from Ebola than adults, they also represented a significant proportion of the people affected by the current outbreak.

Citing findings from its epidemiological research centre, MSF explained that nearly one in four confirmed Ebola cases in North Kivu province was a child.

“MSF is deeply concerned by the disproportionate impact of the disease on children and calls for more attention to their specific vulnerabilities, in both the medical and research response.

“While Ebola remains a deadly disease for all age groups, the youngest children face the highest risk of death. In North Kivu, children have been particularly affected by the current outbreak: 24% of confirmed cases are among children under five years of age, compared with 13% in Ituri province, while infants under one year old account for 13% of cases, compared with 6% in Ituri,” it added.

Noting that its teams at the Ebola treatment centre in Butembo, North Kivu observed that the case fatality rate among children was particularly high, MSF said between June and September 2026, 24 out of 30 children—most of whom were under the age of five—died from the Bundibugyo virus in this ETC alone.

“General health facilities often lack the specialised expertise, equipment, and infection prevention and control measures needed to identify and safely manage suspected cases,” Stéphanie Hoffmann, project coordinator for MSF in Butembo, stated.

Ms Hoffmann disclosed that most paediatric cases admitted to the ETC in Butembo, North Kivu, over the summer had already been hospitalised for other illnesses in several facilities during the days or weeks before their admission.

She added that family members did not have Ebola themselves, and it was highly likely that these children contracted the disease inside healthcare facilities.

MSF stressed that strengthening infection prevention and control measures in health facilities, ensuring the availability of personal protective equipment and reinforcing the training of healthcare workers in non-Ebola health centres across at-risk areas were critical to maintaining essential services while preventing healthcare-associated transmission.

Guyguy Manangama, epidemiologist and deputy director of operations at MSF, stated, “On top of enormous challenges caring for young patients, medical facilities are dealing with a lack of paediatric dosing guidance, and limited availability of child-friendly formulations of investigational medicines. A child-centred approach must be at the heart of medical care, operational planning, and research efforts.”

Mr Manangama stressed that treatments, vaccines and other preventive tools should be evaluated for use in children from the outset of research efforts and made available to them without delay.

MSF urged national authorities, research institutions, pharmaceutical developers and international funders to prioritise the inclusion of children in all ongoing and future Bundibugyo virus studies.